MEDICARE: BERNARD A RAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	31309	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114910510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNARD A RAM MD

Provider Business Mailing Address
First Line	:	58 BIG A ROAD
Second Line	:
City	:	TOCCOA
State	:	GA
Zip	:	30577-6017
Country	:	US
Telephone Number	:	706-886-3151
Fax Number	:	706-282-7781

Provider Business Practice Location Address
First Line	:	58 BIG A ROAD
Second Line	:
City	:	TOCCOA
State	:	GA
Zip	:	30577-6017
Country	:	US
Telephone Number	:	706-886-3151
Fax Number	:	706-282-7781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	05/15/2012

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Directions to “ BERNARD A RAM MD” Practice Location

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